A case Report of Cardiac Hydatid Cyst found during an Emergent Tamponade Surgery in an Unstable Patient

Document Type: Case Report

Authors

1 Assistant Professor, Department of Cardiovascular Surgery, Seyed-al-Shohada Heart Center, Urmia University of Medical Sciences, Urmia, Iran

2 Associate Professor , Department of Cardiology, Seyed-al-Shohada Heart Center, Urmia University of Medical Sciences, Urmia, Iran

3 General Physician, Urmia University of Medical Sciences, Urmia, Iran

Abstract

Cardiac hydatid cysts are uncommon and pericardial involvement is extremely uncommon.
We report a rare case of a cardiac hydatid cyst that was surprisingly found during an emergent tamponade surgery in a woman. She was pale, febrile, ill and toxic and 300cc turbid and purulent fluid was drained. In taking history, it was found that the patient had six sheep dogs in her house. Laboratory analysis revealed elevated C-reactive protein, elevated white blood cell count (neutrophil 80% and eosinophils less than 5%), anemia and negative immunoglobulin ELISA. Complete reevaluation revealed two relatively large hydatid cysts; the biggest one (5cm diameter) was in the lateral side of the left atrium and the other one (2.5cm diameter) was in the inferior of ascending aorta. Surgical removal of the cyst was performed via median sternotomy and cardiopulmonary bypass. The patient had pericarditis, fibrinous adhesions and heart inflammation. Postoperative period was uneventful and the patient received Albendazole for six months. There was no recurrence during the one- year follow-up period.

Keywords


  1. Geramizadeh B. Unusual locations of the hydatid cyst: a review from Iran. Iran J Med Sci 2013; 38(1):2-14.
  2. Hosseinian A, Mohammadzadeh A, Shahmohammadi G, Hasanpour M, Maleki N, Doustkami H, et al. Rupture of a giant cardiac hydatid cyst in the left ventricular free wall: successful surgical management of a rare entity. Am J Cardiovasc Dis 2013; 3(2): 103–6.
  3. Kosecik M, Karaoglanoglu M, Yamak B. Pericardial hydatid cyst presenting with cardiac tamponade. Can J Cardiol 2006; 22(2): 145–7.
  4. Khalkhali HR, Foroutan M, Khademvatan S, Majidiani H, Aryamand S, Khezri P, et al. Prevalence of cystic echinococcosis in Iran: a systematic review and meta-analysis. J Helminthol 2018; 92(3):260-8.
  5. Dalimi A, Motamedi G, Hosseini M, Mohammadian B, Malaki H, Ghamari Z, et al. Echinococcosis/hydatidosis in western Iran. Vet Parasitol 2002; 105(2):161-71.
  6. Bogdanovic A, Radojkovic M, Tomasevic RJ, Pesic I, Petkovic TR, Kovacevic P, et al. Presentation of pericardial hydatid cyst as acute cardiac tamponade. Asian J Surg 2017; 40(2):175-7.
  7. Tuncer E, Tas SG, Mataraci I, Tuncer A, Donmez AA, Aksut M, et al. Surgical treatment of cardiac hydatid disease in 13 patients. Tex Heart Inst J 2010; 37(2): 189–93.
  8. Ohri S, Sachdeva A, Bhatia M, Shrivastava S. Cardiac hydatid cyst in left ventricular free wall. Echo Res Pract 2015; 2(1):K17-9.
  9. Shojaei E, Yassin Z, Rezahosseini O. Cardiac hydatid cyst: a case report. Iran J Public Health 2016; 45(11): 1507–10.
  10. Lainez B, Ruiz V, Berjón J, Lezaun R. Purulent pericarditis complicated by cardiac tamponade secondary to a hydatid cyst-associated hepatic abscess. Rev Esp Cardiol 2009; 62(8):941-54.
  11. Fazlinezhad A, Moohebati M, Azari A, Bigdeloo L. Acute pericardial tamponade due to ruptured multiloculated myocardial hydatid cys. European Journal of Echocardiography 2009; 10(3): 459–61.
  12. Dandan IS, Anand BS, Soweid AM, Abiad F, Talavera F, Ouyang A. Hydatid cysts treatment & management. Medscape; 2017 [cited 2016 Sep 12]. Available from: https://emedicine.medscape.com/article/178648-treatment